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Kasa AS, Traynor V, Drury P. Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study. BMC Geriatr 2024; 24:384. [PMID: 38689218 PMCID: PMC11061989 DOI: 10.1186/s12877-024-04909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite the critical need, interventions aimed at frailty in sub-Saharan Africa are scarce, attributed to factors such as insufficient healthcare infrastructure, the pressing need to address infectious diseases, maternal and child health issues, and a general lack of awareness. Hence, the aim of this research was to develop, implement, and evaluate the effect of a nurse-led program on frailty and associated health outcomes in community-dwelling older individuals in Ethiopia. METHODS This study utilised a pre-test, post-test, and follow-up single-group quasi-experimental design. The main outcome measure was to determine changes in the frailty levels of older individuals living in communities at three different intervals: initially (T0), immediately after the intervention (T1), and 12 weeks following the intervention (T2). Secondary outcomes were the observed changes in daily living activities, nutritional status, depression levels, and quality of life (QOL), evaluated at each of these data collection points. To analyse changes in frailty and response variables over these periods, Friedman's ANOVA and Cochran's Q test were employed, setting the threshold for statistical significance at P < 0.05. RESULTS Sixty-six older people with a high adherence rate of 97% completed the intervention and the follow-up measurements. Participants had an average age of 66.7 ± 7.9 years, with females comprising 79.4% of the group. Notably, 12 weeks post-intervention, there was a marked decrease in frailty (χ2(2) = 101.05, p < 0.001) and depression scores (χ2(2) = 9.55, p = 0.008) compared to the baseline. However, the changes in depression, physical, mental, and environmental domains of QOL were not sustained for 12 weeks post-intervention. Study participants showed an improvement in nutritional status (χ2(2) = 25.68, p < 0.001), activity of daily living (χ2(2) = 6.00, p = 0.05), and global quality of life (χ2(2) = 20.64, p < 0.001). CONCLUSIONS The nurse-led intervention notably, 12 weeks post-intervention reduced frailty and depression. The intervention improved the nutritional status and some components of the quality of life of the participants. There is a need for further studies, especially with larger participant groups and stronger research designs such as randomized controlled trials (RCTs). TRIAL REGISTRATION ClinicalTrials.gov: NCT05754398 (03/03/2023).
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Affiliation(s)
- Ayele Semachew Kasa
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia.
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia
| | - Peta Drury
- School of Nursing, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong (UOW), NSW, Australia
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2
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Cheng M, Wang Y, Wang S, Cao W, Wang X. Network meta-analysis of the efficacy of four traditional Chinese physical exercise therapies on the prevention of falls in the elderly. Front Public Health 2023; 10:1096599. [PMID: 36684937 PMCID: PMC9846771 DOI: 10.3389/fpubh.2022.1096599] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction In recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in older people. However, few studies have evaluated the efficacy of various Chinese traditional exercises in the intervention of falls behavior in the elderly. In this study, four Chinese traditional exercises commonly used in clinical practice were selected as subjects to systematically evaluate the effectiveness of Tai Chi, Ba Duan Jin, Yi Jin Jing and Wu Qin Xi in intervening in the treatment of fall behavior in the elderly. Methods We conducted a systematic review in accordance with the PRISMA guidelines. Four published randomized controlled trials (RCTs) of traditional Chinese exercise interventions for the treatment of falls behavior in older adults were searched through authoritative databases such as CNKI, Web of Science, PubMed, EMbase and the Cochrane Library, all from the time of construction to November 2022. Results A total of 45 studies with 4 traditional interventions were included. Ba Duan Jin was more effective in improving TUGT [SMD = -1.93 (-2.49, -1.38), P < 0.05] and MFES [SMD = -33.45 (-63.93, -2.97), P < 0.05], while Yi Jin Jing was more effective in enhancing ECLSB [SMD = -0.19 (-5.12, -4.74), P < 0.05] and BBS [SMD = -5.79 (-10.80, -0.78), P < 0.05], both of which showed better effects. Discussion The present evidence suggests that all four traditional Chinese body-building exercise therapies have a preventive effect on fall behavior in older adults. In clinical treatment and daily physical exercise, two exercises, BaDuan Jin and Yi Jin Jing, may be preferred to reduce the risk of falls in the elderly, but the exercise regimen of Qigong should be selected scientifically and rationally according to their actual conditions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#myprospero.
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Affiliation(s)
- Meichao Cheng
- School of Physical Education, Shandong University, Jinan, China
| | - Ya Wang
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Shun Wang
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Wenxiao Cao
- School of Physical Education, Huaibei Normal University, Huaibei, China
| | - Xianliang Wang
- School of Physical Education, Shandong University, Jinan, China
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Pereira C, Veiga G, Almeida G, Matias AR, Cruz-Ferreira A, Mendes F, Bravo J. Key factor cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults: the role of physical fitness, body composition, physical activity, health condition, and environmental hazards. BMC Public Health 2021; 21:977. [PMID: 34758785 PMCID: PMC8582090 DOI: 10.1186/s12889-021-10947-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 11/14/2022] Open
Abstract
Background Fall risk assessment and determination of older adults’ individual risk profiles are crucial elements in fall prevention. As such, it is essential to establish cutoffs and reference values for high and low risk according to key risk factor outcomes. This study main objective was to determine the key physical fitness, body composition, physical activity, health condition and environmental hazard risk outcome cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults. Methods Five-hundred community-dwelling Portuguese older adults (72.2 ± 5.4 years) were assessed for falls, physical fitness, body composition, physical (in) activity, number of health conditions and environmental hazards, and sociodemographic characteristics. Results The established key outcomes and respective cutoffs and reference values used for fall risk stratification were multidimensional balance (low risk: score > 33, moderate risk: score 32–33, high risk: score 30–31, and very high: score < 30); lean body mass (low risk: > 44 kg, moderate risk: 42–44 kg, high risk: 39–41 kg, and very high: < 39 kg); fat body mass (low risk: < 37%, moderate risk: 37–38%, high risk: 39–42%, and very high: > 42%); total physical activity (low risk: > 2800 Met-min/wk., moderate risk: 2300–2800 Met-min/wk., high risk: 1900–2300 Met-min/wk., and very high: < 1900 Met-min/wk); rest period weekdays (low risk: < 4 h/day, moderate risk: 4–4.4 h/day, high risk: 4.5–5 h/day, and very high: > 5 h/day); health conditions (low risk: n < 3, moderate risk: n = 3, high risk: n = 4–5, and very high: n > 5); and environmental hazards (low risk: n < 5, moderate risk: n = 5, high risk: n = 6–8, and very high: n > 8). Conclusions Assessment of community-dwelling older adults’ fall risk should focus on the above outcomes to establish individual older adults’ fall risk profiles. Moreover, the design of fall prevention interventions should manage a person’s identified risks and take into account the determined cutoffs and respective interval values for fall risk stratification.
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Affiliation(s)
- Catarina Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.
| | - Guida Veiga
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Gabriela Almeida
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Ana Rita Matias
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Ana Cruz-Ferreira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
| | - Felismina Mendes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza 2B, Évora, Portugal
| | - Jorge Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade de Évora, Largo dos Colegiais 2, Évora, Portugal
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Song CY, Lin PS, Hung PL. Effects of Community-Based Physical-Cognitive Training, Health Education, and Reablement among Rural Community-Dwelling Older Adults with Mobility Deficits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179374. [PMID: 34501963 PMCID: PMC8431322 DOI: 10.3390/ijerph18179374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed to develop and evaluate the effect of community-based physical-cognitive training, health education, and reablement (PCHER) among rural community-dwelling older adults with mobility deficits. The trial was conducted in rural areas of New Taipei City, Taiwan. Older adults with mild to moderate mobility deficits were recruited from six adult daycare centers, and a cluster assignment was applied in a counterbalanced order. The experimental group (n = 16) received a PCHER intervention, comprising 1.5 h of group courses and 1 h of individualized reablement training, while the control group (n = 12) underwent PCHE intervention, comprising 1.5 h of group courses and 1 h of placebo treatment. A 2.5-h training session was completed weekly for 10 weeks. The outcome measures contained the de Morton Mobility Index (DEMMI), the Saint Louis University Mental Status (SLUMS) Examination, the Barthel Index (BI), the Short Physical Performance Battery (SPPB), and the Canadian Occupational Performance Measure (COPM). The PCHER significantly improved the DEMMI, SLUMS, BI, SPPB, and COPM (all p < 0.05), with medium-to-large effect sizes. PCHER also showed an advantage over PCHE in terms of the SPPB (p = 0.02). This study verified that combining individualized reablement with group-based multicomponent training was superior to group courses alone in enhancing the functional abilities of community-dwelling older adults with mobility deficits.
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Affiliation(s)
- Chen-Yi Song
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Correspondence:
| | - Pay-Shin Lin
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Master Degree Program in Healthcare Industry, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Healthy Aging Research Center, Chang Gung University, Chang Gung Memorial Hospital, Taoyuan 33302, Taiwan
| | - Pei-Lun Hung
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
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Lima M, Rodrigues SR, Bezerra P, Rodrigues LP, Cancela JM. Monitorization of Timed Up and Go Phases in Elderly. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1836111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Miguel Lima
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
| | - Sílvia Rocha Rodrigues
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, Porto, Portugal
| | - Pedro Bezerra
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
| | - Luís Paulo Rodrigues
- Escola Superior de Desporto e Lazer de Melgaço, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Center, Sports Sciences Health and Human Development, CIDESD, Vila Real, Portugal
| | - José Maria Cancela
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
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Kováčiková Z, Sarvestan J, Zemková E. Age-related differences in stair descent balance control: Are women more prone to falls than men? PLoS One 2021; 16:e0244990. [PMID: 33411803 PMCID: PMC7790224 DOI: 10.1371/journal.pone.0244990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/18/2020] [Indexed: 12/03/2022] Open
Abstract
Stair descent is one of the most common forms of daily locomotion and concurrently one of the most challenging and hazardous daily activities performed by older adults. Thus, sufficient attention should be devoted to this locomotion and to the factors that affect it. This study investigates gender and age-related differences in balance control during and after stair descent on a foam mat. Forty-seven older adults (70% women) and 38 young adults (58% women) performed a descent from one step onto a foam mat. Anteroposterior (AP) and mediolateral (ML) centre of pressure velocity (CoP) and standard deviation of the CoP sway were investigated during stair descent and restabilization. A two-way analysis of variance (ANOVA) revealed the main effects of age for the first 5 s of restabilization. Older women exhibited significantly higher values of CoP sway and velocity in both directions compared to the younger individuals (CoP SDAP5, 55%; CoP SDML5, 30%; CoP VAP5, 106%; CoP VML5, 75%). Men achieved significantly higher values of CoP sway and velocity only in the AP direction compared to their younger counterparts (CoP SDAP5, 50% and CoP VAP5, 79%). These findings suggest that with advancing age, men are at higher risk of forward falls, whereas women are at higher risk of forward and sideways falls.
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Affiliation(s)
- Zuzana Kováčiková
- Faculty of Physical Culture, Department of Natural Sciences in Kinanthropology, Palacký University Olomouc, Olomouc, Czech Republic
- * E-mail:
| | - Javad Sarvestan
- Faculty of Physical Culture, Department of Natural Sciences in Kinanthropology, Palacký University Olomouc, Olomouc, Czech Republic
| | - Erika Zemková
- Faculty of Physical Education and Sports, Department of Biological and Medical Sciences, Comenius University in Bratislava, Bratislava, Slovakia
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Selected Tools for Assessing the Risk of Falls in Older Women. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2065201. [PMID: 33274197 PMCID: PMC7683108 DOI: 10.1155/2020/2065201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 12/25/2022]
Abstract
Methods Fifty-five females were examined (May 2018-June 2019). Stabilographic examinations were performed with eyes open (EO) and closed (EC). An analysis of variance (ANOVA) and Spearman rank correlation were performed to determine the relationships and differences between the above tests. Results The results of the TUG correlate with the overall stability index (OSI) EO (r = 0.314), medial-lateral stability index (MLSI) EO (r = 0.297), and fall risk index (FRI6-2; r = 0.435) in stabilographic examinations and the FRT (r = −0.399). The results of the modified Unterberger test correlate with MLSI EO (r = 0.276), OSI EC (r = 0.310), and MLSI EC (r = 0.378). There are statistically significant differences between faller and nonfaller groups in TUG (p = 0.0068), FRT (p = 0.001), and MLSI EO (p = 0.0118). Conclusions The modified Unterberger test and TUG can be considered effective in functional FR assessment in older women. Using at least two different functional tests may improve the assessment of FR.
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Choi W, Han C, Lee S. The effects of head rotation exercise on postural balance, muscle strength, and gait in older women. Women Health 2019; 60:426-439. [PMID: 31587622 DOI: 10.1080/03630242.2019.1662870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed to evaluate the effects of resistive exercise (RE) with head rotation exercise (RE+HRE) on postural balance, lower limb muscle strength, and gait in older women. This study was conducted from December 7, 2015 to January 29, 2016 in Seoul, South Korea. Forty older women were recruited at welfare center and randomly allocated to RE+HRE (n = 20) or RE (n = 20) groups. The RE+HRE group performed RE+HRE for 60 min twice per week for 6 weeks, using an elastic band with variable resistance along the length. The HRE included horizontal or vertical head movement during the exercise. The RE group performed RE in a similar manner, but without head movements. The outcome measures were static postural balance (one-leg stance test, functional reach test, and postural sway), dynamic postural balance (timed up and go test, four square step test, and Mini-balance evaluation systems test), lower limb muscle strength (sit-to-stand test), and temporal gait parameters. In the RE+HRE group, all variables were significantly improved compared to baseline (p < .05), and postural balance and gait were significantly improved compared to those in the RE group (p < .05). These findings suggest that RE+HRE can improve dynamic postural balance, gait speed, and cadence in older women.
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Affiliation(s)
- Wonjae Choi
- Physical Therapy, Institute of SMART Rehabilitation, Sahmyook University, Seoul, Korea (the Republic of)
| | | | - Seungwon Lee
- Physical Therapy, Institute of SMART Rehabilitation, Sahmyook University, Seoul, Korea (the Republic of).,Physical Therapy, Sahmyook University, Seoul, Korea (the Republic of)
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Clinical Relevance of a Balance Training Program on Liver Transplant Patients. A Randomized Controlled Trial. Transplantation 2019; 103:965-972. [DOI: 10.1097/tp.0000000000002415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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